BREAKING: IT’S ALIVE – The new insurance portal HealthCare.gov launched beats its July 1 deadline, launching late last night with approximately 500 pages of content and state-by-state listings of more than 5,500 open health insurance products.

NEXT STEPS -- “In October, 2010, price estimates for health insurance plans will be available,” an administration official promises. “This additional information will allow Americans to compare insurance policy costs the same way they compare the price of airline tickets and help bring about even more competition into the marketplace.”

By Sarah Kliff and Jennifer Haberkorn

Good Thursday Morning. Happy Canada Day from Pulse’s resident Canuck. “With glowing hearts we see thee rise, the true Pulse strong and free.”

INSURER REAX -- Insurers balked, in public comments and conversations with PULSE, at the extensive data HHS requested to build HealthCare.Gov, particularly on plans closed to new business. Some got more skittish after a May 7 conference call with private insurers, where an HHS official said the agency wanted to “collect the universe of products.” Insurers wondered: what collecting a “universe of products” have to do with serving consumers who cannot enroll in closed plans? Insurers will monitor the October launch closely to see whether the data lands online there—or if it turns up elsewhere.

ALSO IN HCR LAUNCHES -- Applications for the federal Preexisting Condition Insurance Plan are out this morning on another new site, PCIP.gov. Qualified applications received by July 15 will begin coverage on Aug. 1; premiums range from $140 to $900 per month, varying by age and geography.

SCOOP: AHIP’S NEW CHAIR -- The insurance lobby will announce Vicky Gregg, current president of BlueCross BlueShield of Tennessee, as its new chair. An internal AHIP memo obtained by PULSE, praises Gregg as a registered nurse with “more than 25 years of experience in diverse health care environments including clinical care, hospital administration, long-term care, and health care benefits and financing.” As chair, Gregg has the power to set AHIP’s agenda in a critical year.

** A message from the Coalition to Protect America’s Health Care: Congress needs to extend the enhanced FMAP now. If Congress doesn’t act, states will be forced to cut Medicaid for millions of low-income children, seniors and Americans with disabilities. America’s banks got a second chance. Don’t America’s families deserve the same? Learn more at www.protecthealthcare.org **

AFFORDABLE CARE ACT = $900 PREMIUMS? PCIPs, while undoubtedly cheaper than many individual market products, will still be too expensive for some. “While there is a significant number of people with pre-existing conditions who are uninsured, a significant number also have limited income…while they may need this plan, the premiums may not be something they can afford,” says OCIIO’s Richard Popper. ELEPHANT IN THE ROOM --Multiple projections don’t see the $5 billion lasting until 2014. Will HHS cap enrollment? Reduce benefits? Up premiums or deductibles? The agency has stayed mum on the subject, shying away from such questions to frame the PCIPs as “a bridge to 2014” that, while imperfect, does undoubtedly improve the insurance landscape.

PULSE EXCLUSIVE: TAN TAX OPPOSITION (IT’S NOT SNOOKI!) -- The Indoor Tanning Association, Americans for Tax Reform, National Taxpayers Union and DeFundIt.org will call for a repeal of the new 10 percent tax on indoor tanning services, effective today. “This tax will add yet another burden on tanning salons at a time when they can least afford it, forcing many salons to close, lay off employees, stop providing health insurance for employees, and pass on higher costs to our customers while many of their incomes have dramatically declined,” the groups write in a letter due to be sent to lawmakers today. “Additionally in an equal democracy such as the United States of America, it is wholly unfair to single out for punishment a specific industry such as tanning.” The letter http://politi.co/bjB4aN

BY THE NUMBERS -- NFIB and the Indoor Tanning Association say the tax would hit an estimated 18,000 businesses.

ACROSS THE POTOMAC -- Oral arguments begin today in Richmond for Virginia’s lawsuit against the federal government, challenging the constitutionality of the overhaul. The judge hears the government’s case that the suit be thrown out.

PULSE POLITICS: PERRIELLIO GINGERLY WADES INTO THE DEBATE -- In VA-05, conservatives have hit freshman Democrat Tom Perriello hard for his pro-reform vote. GOP opponent Robert Hurt’s latest web ad focuses on “Pelosi-Obamacare;” Americans for Prosperity had a spot earlier in June. Now, Perriello fires back—but he’s not trigger happy. A 60-second spot out Wednesday, does not mention reform by name, but rather touts “lowered prescription drug costs for seniors and strengthened Medicare” as a stand alone benefit. Perriello has treaded lightly before, in April, when he told a tele-townhall that health repeal lawsuits were “an appropriate gesture.”

Perriello spokeswoman Jessica Barba says the Congressman won’t run from his vote: “Tom is ready for that discussion with Senator Hurt. He has been very diligently going out to his constituents and really explaining what this bill means.” Bring it on, says Hurt’s campaign: a poll during the health reform debate found only 32 percent of VA-05 to support the bill, 52 percent to oppose. Perriello ad: http://bit.ly/dvsgk2

HealthCare.Gov Launches Just Ahead of Schedule --Small Business Revolts on New Tanning Tax -- Health Repeal Arguments Open in Virginia

FMAP UPDATE --The Senate left town for its Fourth of July break Wednesday, so nothing's likely to get done for a while. Sen. Scott Brown introduced a bill to provide FMAP funding for a year, but it’s gradually phased out over time. The bill is paid for with unspent stimulus money, meaning it’s likely a no-go with Dems.

“GOING TO TRY” -- Gov. Rendell gathered five Democrat governors to press their case for the FMAP extension in D.C. on Wednesday; four more (2 Dem, 2 GOP) joined via video conference. The rhetoric was united and clear --“Our plea is to beg Congress, particularly the Senate, to find the votes,” as Michigan’s Granholm put it -- but a path forward was anything but clear-cut. While more than half met with their Congressional delegations, none had come out with an assurance of the next steps. “We’ve heard they were going to try,” is how Rendell put it.

CBO’S LONG-TERM BUDGET REPORT – HEALTH UPDATE EDITION!

SHOT -- CBO says “rapidly rising health care costs” and an aging population will “sharply increase” federal spending on health care and Social Security, making the case that the overhaul won’t have much impact on health care costs. Government debt is expected to hit its highest levels since shortly after World War II. CBO Director Doug Elmendorf told Congress that the health care overhaul made “small steps” on the long journey toward fiscal responsibility.

CHASER - OMB Director Orszag responds: “The report confirms that the enactment and successful implementation of the Affordable Care Act is a key step toward a healthier fiscal future,” he writes. But it’s not a cure-all. “Make no mistake—we remain on an unsustainable fiscal path, even after enactment of the Affordable Care Act.” http://bit.ly/b70wfR

STENY HOYER, VOICE OF REASON? “The CBO has once again pointed out that health insurance reform will reduce our deficit significantly this decade, and even more in the decade to follow. But that projection will only hold true if Congress follows through, as it must, on the important measures to contain costs.” (Which is to say -- those cuts to doctors’ payments that never seem to come to fruition.)

HAPPENING TODAY - The House Education and Labor Committee examines the Improving Nutrition for America’s Children Act, which would try to improve the nutritional quality of school meals by establishing nutrition standards for foods sold outside of cafeterias, among other things. . . Sen. Tom Carper’s hearing examines the pilot program that recovered more than $900 million in Medicare overpayments.

WOULD KAGAN HAVE TO RECUSE HERSELF IF REFORM GOT TO THE COURT?

“That’s possible, and we’ll need to pursue that,” Ranking Judiciary Member Jeff Sessions said on FOX Wednesday. “She’s been reluctant to say she would recuse herself on a lot of these issues… And I took her answers to the good questions of Senator Coburn about the Commerce Clause and health care as been pretty expansive and pretty supportive of government reach. So I was not encouraged by that.”

WHAT WE’RE READING

GOOD POINT -- Notably absent in the deluge of trade association Berwick endorsements: AHIP. NYT’s Reed Abelson: “Nothing personal, according to Robert Zirkelbach, a spokesman for the association. ‘Dr. Berwick has a long track record of working on quality issues,’ he said, although he noted that some health insurers remain concerned about the cuts to payments for private health plans who cover people enrolled in Medicare. He also noted that the association did not sign similar letters of support for other recent nominees to head Medicare, like Thomas Scully and Dr. Mark McClellan.” http://nyti.ms/cAiA2U

SHORT TERM BUYERS UP MASS. COSTS -- Boston Globe: “The number of people who appear to be gaming the state’s health insurance system by purchasing coverage only when they are sick quadrupled from 2006 to 2008, according to a long-awaited report released yesterday from the Massachusetts Division of Insurance.” http://bit.ly/9sCb8t

** A message from the Coalition to Protect America’s Health Care: Congress needs to extend the enhanced FMAP now. If Congress doesn’t act, states will be forced to cut Medicaid for millions of low-income children, seniors and Americans with disabilities.

In a tough economy, Congress did the right thing last year by providing states with additional resources to protect access to health care. But with the expiration date quickly approaching and 47 states facing record budget shortfalls, we need Congress to extend these additional Medicaid funds to the states for another six months. As America moves forward, we can’t leave our most vulnerable behind.
Learn more at www.protecthealthcare.org **